Primary squamous cell carcinoma of the thyroid: an unusual presentation.

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare malignancy with a poor prognosis. PSCCT usually presents as an enlarging neck mass and can cause stridor, hoarseness, and shortness of breath because of its penchant for local invasion. Long-term survival requires early detection and complete surgical excision, as the tumor is resistant to chemotherapy and radiation therapy. We present a patient with PSCCT without evidence of neck mass on presentation, who presented instead with shortness of breath, stridor, and evidence of an upper airway obstruction on spirometry. Recognition of a possible airway obstruction led to bronchoscopy, identification of the endobronchial obstruction, and successful definitive resection of the malignancy.